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Let me start by saying that overall i think dentists are well meaning people who have been misinformed about the safety of dental mercury. My articles deconstructing further misinformation spread by dentists are in no way a character attack on any particular dentist, but rather a record of correction to the misleading information they are providing that can be extremely detrimental to the health of their staff, patients and themselves.

Dr. Chie Li Ee website states: “Dr. Chie Li Ee firmly promotes healthy living principles for himself and all those around him.” With this in mind he will hopefully investigate further into the many large doses of mercury exposures he is subjecting himself, staff and patients to.

Mercury has long been known to be toxic to humans in greater than recommended doses, either in its elemental, inorganic or methylmercury forms. Prolonged exposure to mercury has been linked chronic illnesses, autoimmune conditions, neuro-degenerative diseases, birth defects, oral lesions and mental disorders.

Mark Richardson PhDdiscusses the findings of his dental amalgamrisk assessment study, published in 2011

Dr. CHIE is absolutely correct that mercury is toxic to humans, although he is off when stating “in quantities greater than recommended safety levels”. The World Health Organization has determined that there is “no safe level of mercury exposure”. In 2010 an amalgam risk assessment (published in the journal of ) was presented to the FDA. The study found that over 60 million people are exposed to doses of mercury (from amalgams) higher than what the EPA says is safe. That number shoots up to 120 million people if the California EPA’s mercury safe level is used. EPA’s mercury safe dose was calculated over 20 years ago, while California’s was calculated in 2008 and is 10 times lower than national EPA.

Silver amalgam (dental amalgam) is a mixture of approximately 50% elemental liquid mercury, 35% silver, 9% tin, 6% copper and trace amounts of zinc. Amalgam has been the most popular and effective restorative material used in dentistry for more than 150 years.

The popularity of amalgam is mostly due to its strength, ease of use and lower cost.

James Adams PhDdiscusses the increase in mercury releasedby high copper mercury fillings

The increased strength of amalgam has come about by increasing the copper content. This has had the unintended consequence of increasing the amount of mercury released substantially. James Adams PhD presents data showing a single spill high copper amalgam filling releases roughly 300 micrograms initially after placement and 782 micrograms of mercury in the first week. This is several hundred percent more mercury than what non-high copper amalgams released during the first few days of placement. (102 micrograms on day one and 160 micrograms for the week)

Despite the long history and popularity of dental amalgam as a restorative material, there have been periodic concerns regarding the potential adverse health effects arising from exposure to mercury in amalgam.

It is perhaps good to inform ones self on the actual history of dental mercury fillings so as to have the context for the above statement. Here is David Kennedy DDS presenting his overview of dental mercury fillings to the FDA dental products panel in 2010.

When the amalgam is first mixed, it is a soft paste that is inserted into the cavity, which hardens in about 30 minutes. Once amalgam is hard, mercury is bound within the amalgam; but very small amounts are slowly released due to corrosion or chewing or grinding motions.

Using the word “bound” implies that mercury does not escape, but then in the next sentence Dr. Chie Li Ee states “small amounts of mercury are released”. For the record. Freshly mixed amalgam fillings release hundreds of micrograms which does not trail off until after the first week placed. Hundreds of micrograms can in no way shape or form be considered “small” as Dr. Chie Li Ee DMD implies. Additionally amalgams continually release mercury vapor even when not agitated. But they do release considerably higher amounts of mercury when subjected to any kind of friction, heat, dissimilar metals or chemicals.

The amount of mercury released from dental amalgam depends on the total number of fillings and chewing and heating habits of the person and other chemical conditions in the mouth. Studies relating to the amount of mercury leached from fillings vary widely and whether such amounts present significant health risks.

The ADA has promoted the absurd figure that it would take somewhere close to 500 mercury fillings to allow someone to be mercury toxic. This is of course based on junk science of the worst kind, that meant to mislead people about the safety of a potent neurotoxin placed within inches of ones brain. In this video Boyd Haley PhD dismantles the ADA claim that “only minute amounts of mercury are released from dental amalgam fillings” highlighting the deficiencies of the study by Rodney Mackert upon which they rely: “Mercury Exposure From Dental Amalgam Fillings: Absorbed Dose and the Potential for Adverse Health Effects”

Of the three forms of mercury, elemental mercury is the most volatile and mercury vapor is the most predominant form. Sources of mercury in drinking water and food are generally inorganic and organic mercury compounds, with organic compounds being particularly associated with seafood.

Context alert. Our government has taken great strides to reduce the USA population to mercury as evident by the warnings on the mercury content in fish. The World Health Organization has determined that ones exposure to mercury from fish is roughly 3 micrograms. Where as dental amalgam subjects people to anywhere from 1 – 27 micrograms (WHO 2003). Does anyone here see a problem ? Do you think it ethical to say amalgams are “safe” when put in this context?

Many patients request replacing their old silver fillings with other restorative alternatives for fear of mercury toxicity. However, removing those amalgam fillings actually creates mercury vapors that in itself may increase its exposure to the patient if certain precautions are not taken.

Unfortunately Dr. Chie Li Ee does not share how high those mercury levels go. The levels of mercury vapor and mercury contaminated particulate matter are worth mentioning as they expose dental staff and patients to tens of thousands of micrograms per single amalgam removed. Dr. Chie Li Ee probably removes aged amalgams every single day without protecting staff or patients to the enormous amount of mercury that would be generated the process. It is worth noting that Dr. Chie Li Ee is ignoring the warning laid out in the amalgam material safety data sheet (MSDS) and current OSHA hazards regulations.

It is important to note that the American Dental Association (ADA), Centers for Disease Control and Prevention (CDC), and the Food and Drug Association (FDA) all maintain that there is inadequate data linking dental amalgam to any human health detriments and concluded that amalgam is a safe and effective restoration.

Ah, the old fall back of using statements of safety from authoritative organizations. While he is right, that those organizations do say that, unfortunately it is not in line with what the vast majority of science on the health hazards of mercury vapor find. What is more probable, that mercury under every other circumstance is hazardous (must be treated as hazardous waste before it is placed in the mouth and after it is removed from the mouth.) or that the dental profession is trying to protect its members from mass litigation or some other unknown reason. Once one is aware of the vast number of scandals the FDA has been involved in with the amalgam issue, it becomes quite clear that most of organized dentistry have no idea what they are talking about when promoting mercury fillings as safe. In addition flatly stating that amalgams are safe totally ignores the acknowledged sub-populations who are more susceptible to harm from mercury fillings, such as pregnant women, children, the elderly and those with kidney disease. It should come as no surprise the FDA’s amalgam risk assessment contained over 20 serious flaws, as outlined by Jim Love of the International Academy of Oral medicine and Toxicology.

Alternatives to amalgam restorations include composite resin materials, porcelain and gold. Composite resins are polymers that although have lower strength properties than amalgam, are more esthetic and have physical properties similar to tooth dentin.

To say that composite resins have lower strength properties is to ignore recent studies from the last several years showing otherwise

Porcelain and gold are far more expensive than amalgam and technique sensitive. It is important to discuss the restorative options with your dentist to determine what may be the best option for you.

In addition to health concerns, opponents to dental amalgam fillings point to the negative externalities of water contamination and environmental damage of mercury. The State of New Jersey now mandates that all dental offices in New Jersey install amalgam separators to decrease the release of mercury into the public sewer system.

For over 100 years dentists have been significant mercury polluters, contaminating the environment for as long as they have used mercury fillings without fear of regulation. Last year the EPA announced that dentists nationwide were going to be mandated to install amalgam separators to capture 99.9% of the mercury waste before it is released into the environment. Dave Simone of The International Academy of Oral Medicine and Toxicology shares his experieinces at the second session of the Intergovernmental Negotiating Committee to prepare a global legally binding instrument on Mercury (INC2) which was held in Chiba, Japan from 24 to 28 January, 2011.

In conclusion, this author is of the view that silver amalgam is a safe restorative material and that there are other more esthetic and comparable materials for those who continue to have concerns regarding its health risks. Old amalgam restorations may be replaced should there be decay or fracture or any such need to do so.

Questions and concerns pertaining to your amalgam restorations may be addressed to Dr. Chie Li Ee at 609-884-5335.